End-of-Life Terminology: A Pontifical Academy LexiconEnd-of-Life Terminology: A Pontifical Academy Lexicon The Pontifical Academy for Life has identified an increasing public debate on end-of-life issues, fueled by social media and legislative considerations. To facilitate constructive discussions, the Academy has compiled a lexicon of key terms, highlighting the Catholic Church’s perspective and linking them to fundamental principles. Key Terms and Definitions Some of the terms covered in the lexicon include: * Vegetative state and coma: Defined by precise medical criteria. * Palliative care and deep sedation: Focuses on relieving suffering without hastening death. * Euthanasia and assisted suicide: Intentional killing of a person, considered a violation of human life. * Determination of death: Based on irreversible cessation of brain function. * Organ donation: Consent-based removal of vital organs for transplantation. * Life-sustaining care: Essential treatment that maintains vital functions. * Artificial nutrition and hydration: Medical interventions to provide nourishment and hydration. * “Aggressive” medical treatment and its withdrawal: May become disproportionate and inappropriate when the intended benefits are outweighed by burdens. * Model living will: A guide for individuals to express their preferences regarding end-of-life care. Underlying Principles The lexicon emphasizes several fundamental principles that shape the Catholic perspective on end-of-life issues: * Freedom and responsibility: God-given freedom should be exercised responsibly, considering the well-being of others. * Medical care’s purpose: To preserve life and alleviate suffering, enabling communication and relationship-building. * Relationship and dialogue: Patients, healthcare providers, family, and society should engage in open and informed discussions to make ethical choices. Avoiding Misconceptions The lexicon also addresses common misconceptions, such as: * Pain is celebrated as a path to salvation: Christian faith encourages pain relief through medical care. * Patient autonomy is absolute: Autonomy must be exercised in dialogue with healthcare professionals and consider others’ well-being. Call for Dialogue Archbishop Vincenzo Paglia, President of the Pontifical Academy for Life, stresses the importance of sincere and profound dialogue in end-of-life discussions. He urges all parties to approach these conversations with a shared respect for human dignity.
Public debate on end-of-life issues appears to be broadening as states and nations consider new bioethics laws and thanks to social media, according to the president of the Pontifical Academy for Life.
The increased participation of individuals and groups in these debates is to be welcomed, because the final stage of life is an important issue that concerns everyone, Archbishop Vincenzo Paglia said in the introduction to a new booklet from the Pontifical Academy.
But precisely because the debate has spread so widely, there are often errors, confusion and gaps in people’s knowledge of certain end-of-life terminology, which can hinder constructive discussion and solutions, he wrote.
That is why the academy decided to compile a short ‘lexicon’ of key terms used in many discussions about the end of life, to help Catholics better navigate this often complex debate.
Written by a group of academy members, the 80-page booklet focuses on 22 terms and offers: easy-to-understand, precise definitions based on the latest science; the theology behind the Catholic Church’s position on end-of-life issues; a look at the evolution of Church teaching on the issue; and current Italian legislation regarding end-of-life issues. Published only in Italian, it was released on July 2 by the Vatican publishing house.
The academy has distributed the booklet to all bishops in Italy, informing them that it is particularly suitable for priests, deacons, religious and people who work or provide advice in health care.
The purpose of the lexicon, Archbishop Paglia wrote, is to cut through “the jungle of complicated issues” and present a clear, correct use of terminology. In this way, those interested in end-of-life conversations can find a common ground of shared meanings before embarking on the more difficult task of understanding the differing positions and goals of others.
An important feature of the booklet is the way in which the topics are presented from the perspective of the Catholic view and how they are linked together by several fundamental principles, such as the Christian meaning of life, death, freedom, responsibility and care.
One principle is freedom as a gift from God that leaves humanity “freely deciding about our lives,” Archbishop Paglia wrote. “But free does not mean arbitrary, but (it means) responsible” and always in relation to other people and the world at large.
“Being responsible for oneself,” he wrote, “is always a way of being responsible — or irresponsible — for others. That is the way we humans live to the end.”
Topics covered include: the ‘vegetative state’ and coma; cremation; palliative care and deep sedation; management of suffering and pain; euthanasia and assisted suicide; intensive care, including for terminally ill babies; determination of death; organ donation; life-sustaining care; artificial nutrition and hydration; ‘aggressive’ medical treatment and its withdrawal; ordinary and proportionate means of preserving life; and guidelines for preserving life, including a model living will that you can adapt with the guidance of a priest.
The experts from the Pontifical Academy who compiled the book drew on many sources, basing themselves primarily on the teachings of John Paul II and Pope Francis, but also on numerous documents issued by the then Congregation and now Dicastery for the Doctrine of the Faith. These documents are all available online.
While the booklet itself contains nothing new, it offers a concise, faith-based explanation of end-of-life issues in the context of current laws, trends and ‘secular’ attitudes.
For example, regarding euthanasia, the brochure warns that legalising it could lead to a multitude of dangers that go beyond the deliberate violation of human life: it compromises the role of the physician, whose mission is to care for patients and preserve their lives, it may lead to less support for assisted dying by natural means, and it undermines the freedom of people who may feel pressured to request euthanasia to avoid becoming a burden on their families or society.
The goal of medical treatment and care for people facing the end of life is to relieve pain in a way that enables the patient to be aware, communicate, and maintain and deepen relationships.
In fact, it is not true that pain is “celebrated” in the Christian faith as “a path to salvation,” the booklet states. It is both a professional duty and an act of Christian charity for medical personnel to help relieve suffering.
The underlying theme in the booklet is the importance of maintaining and strengthening the relationship and dialogue between patient and healthcare providers, family and society.
It was emphasized that there is a way to respect and protect patients’ autonomy and freedom to make their own decisions about palliative care without isolating them in a subjective bubble.
Autonomy always exists in relation to others, it said. The patient must be in dialogue with medical professionals who carefully study the individual’s unique case and fully inform the patient and family in order to follow a path of shared decision-making.
“Communication between a physician and a patient – and with family members – is critical in making ethical choices about treatment changes,” the report said.
An open, honest and informed dialogue must also be the basis for those who participate today in debates and discussions on end-of-life issues, Archbishop Paglia said in the booklet’s introduction.
Only “sincere and profound dialogue,” and not “pre-programmed and partisan ideologies, can lead to authentic shared solutions,” he wrote. Dialogue from all sides, religious or not, must be driven by a sincere quest to respect human beings, he added.
